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Kidney Week

Abstract: FR-PO1145

Immunosuppression Management in Kidney Transplant Recipients with Malignancy/Mortality and Renal Graft Outcome

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Thamcharoen, Natanong, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
  • Yang, Danwen, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
  • Cardarelli, Francesca, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
Background

Kidney transplant recipients(KTR) are at high risk of cancer compared to general population.Prognosis is poor and the data of how to manage immunosuppression(IS) after cancer diagnosis is scarce.We aims to assess the impact of IS dose reduction on graft survival and mortality outcome in KTR diagnosed with cancer.

Methods

We retrospectively reviewed and collected the data of KTR with cancer diagnosis after kidney transplant.Early stage non-melanoma skin cancer was excluded.We divided our study population in 2 groups,IS reduction and no reduction.Study outcomes were mortality and graft failure. Follow-up time was 10 years.Data were calculated as percentages for categorical variables and mean or median for continuous variables.Patient survivals and graft survivals were analyzed using Kaplan-Meier survival curves with log-rank test.Competing risk analysis was used for graft failure outcome and Cox proportional hazards was used for mortality analysis.

Results

There were 110 patients in total.The mean age at cancer diagnosis was 60.2 years. IS was changed in 74%.Solid organ tumor was 79.1%.Mortality rate was 46.4 % with median survival time of 1.8 years after cancer diagnosis.Graft failure rate was 16.4%.Median graft survival was 2.97 years.Kaplan-Meier curves showed that IS reduction was associated with higher mortality risk and graft failure.However, from multivariable models,history of chemotherapy was the only factor associated with increased mortality(image1).Creatinine at cancer diagnosis and history of rejection were significant predictors of graft failure(image2).

Conclusion

Reduction of IS after cancer diagnosis was not significantly associated with patient mortality,nor with increased risk of kidney allograft failure.

Image 1

Image2